From the Guidelines
For mild bunions, the most effective treatment approach is to wear properly fitting shoes with a wide toe box and low heels, and consider using custom or over-the-counter orthotic inserts to reduce pressure on the bunion, as recommended by the most recent guidelines 1. This approach is supported by the latest evidence, which emphasizes the importance of well-fitted shoes and orthotic inserts in managing bony deformities such as bunions 1. Key components of this treatment plan include:
- Wearing shoes with a broad and square toe box to reduce pressure on the bunion
- Using custom or over-the-counter orthotic inserts to distribute pressure evenly across the foot
- Avoiding high heels and tight shoes that can exacerbate the condition
- Considering the use of bunion pads or cushions to protect the affected area from friction
- Ice the bunion for 15-20 minutes several times daily to reduce inflammation
- Toe spacers or splints worn at night may help maintain proper alignment
- Regular toe exercises, such as picking up marbles with the toes or toe stretches, can strengthen foot muscles and improve flexibility It is essential to note that while these conservative treatments can be effective in managing mild bunions, if pain persists or the bunion worsens, consultation with a podiatrist for additional treatment options, including prescription orthotics or surgical intervention, may be necessary 1.
From the Research
Treatment Options for Mild Bunions
- Initial treatment of symptomatic bunions should be non-operative, as stated in the study 2
- Accommodative footwear is an important aspect of non-operative treatment, according to 2
- There is evidence supporting the use of:
- Nonsteroidal anti-inflammatory drugs
- Orthotics
- Splints/braces
- Toe spacers, as mentioned in 2
- However, these may not provide long-term relief, and referral to an orthopaedic surgeon is recommended if the patient has a painful prominence, has exhausted non-operative treatment, and is a suitable operative candidate, as stated in 2
Conservative Treatments
- A systematic review found 21 systematic reviews, RCTs, or observational studies that met the inclusion criteria for conservative treatments, surgery, and postoperative care for bunions, as reported in 3
- The review presents information relating to the effectiveness and safety of various interventions, including:
- Arthrodesis (Lapidus procedure)
- Bone fixation
- Chevron osteotomy plus adductor tenotomy
- Distal metatarsal osteotomy
- Early weight-bearing
- Keller's arthroplasty
- Night splints
- Orthoses, as mentioned in 3